Electrical dipoles oriented perpendicular to the cortical surface are the primary source of the scalp EEGs and MEGs. Thus, in particular, gyri and sulci structures on the cortical surface have a definite possibility to influence the EEGs and MEGs. This was examined by comparing the spatial power spectral density (PSD) of the upper portion of the human cortex in MRI slices to that of simulated scalp EEGs and MEGs. The electrical activity was modeled with 2,650 dipolar sources oriented normal to the local cortical surface. The resulting scalp potentials were calculated with a finite element model of the head constructed from 51 segmented sagittal MR images. The PSD was computed after taking the fast Fourier transform of scalp potentials. The PSD of the cortical contour in each slice was also computed. The PSD was then averaged over all the slices. This was done for sagittal and coronal view both. The PSD of EEG and MEG showed two broad peaks, one from 0.05 to 0.22 cycles/cm (wavelength 20–4.545 cm) and the other from 0.22 to 1.2 cycles/cm (wavelength 4.545–0.834 cm). The PSD of the cortex showed a broad peak from 0.08 to 0.32 cycles/cm (wavelength 12.5–3.125 cm) and other two peaks within the range of 0.32 to 0.9 cycles/cm (wavelength 3.125–1.11 cm). These peaks are definitely due to the gyri structures and associated larger patterns on the cortical surface. Smaller peaks in the range of 1–3 cycles/cm were also observed which are possibly due to sulci structures. These results suggest that the spatial information was present in the EEG and MEG at the spatial frequencies of gyri. This also implies that the practical Nyquist frequency for sampling scalp EEGs should be 3.0 cycles/cm and an optimal interelectrode spacing of about 3 mm is needed for extraction of cortical patterns from scalp EEGs in humans.

-Our objective was to examine if the high-density, 256 channel, scalp interictal EEG data can be used for localizing the epilepsy areas in patients. This was done by examining the long-range temporal correlations (LRTC) of EEGs and also that of the phase synchronization index (SI) of EEGs. It was found that the LRTC of scalp SI plots were better in localizing the seizure areas as compared with the LRTC of EEGs alone. The EEG data of one minute duration was filtered in the low Gamma band of 30-50 Hz. A detrended fluctuation analysis (DFA) was used to find LRTC of the scalp EEG data. Contour plots were constructed using a montage of the layout of 256 electrode positions. The SI was computed after taking Hilbert transform of the EEG data. The SI between a pair of channel was inferred from a statistical tendency to maintain a nearly constant phase difference over a given period of time even though the analytic phase of each channel may change markedly during that time frame. The SI for each electrode was averaged over with the nearby six electrodes. LRTC of the SI was computed and spatial plots were made. It was found that the LRTC of SI was highest at the location of the epileptic sites. A similar pattern was not found in the LRTC of EEGs. This provides a noninvasive way to localize seizure areas from scalp EEG data.

Kleine-Levin syndrome (KLS) is a rare sleep disorder characterized by periodic hypersomnia and various degrees of cognitive and behavioral disturbance, hyperphagia, and hypersexuality. Effective treatment is challenging. Stimulants marginally address sleepiness, but may increase irritability and do not improve cognitive and behavioral disturbances. Modafi nil may shorten the symptomatic period but not the recurrence rate. Lithium and carbamazepine are benefi cial in some cases, possibly related to similarities between KLS and affective disorders. Currently, no single medication is consistently successful in treating the syndrome. Here we report the shortterm effect of clarithromycin in a patient with KLS. C A S E R E P O R T SK leine-Levin Syndrome (KLS) is a rare sleep disorder of unknown cause characterized by repetitive, intermittent cycles of extreme sleepiness, and cognitive/behavioral disturbances including confusion, feelings of unreality, aggressiveness, and hypersexuality. Gamma-aminobutyric acid (GABA) is the predominant inhibitory neurotransmitter in the brain with well-known effects on sleep/wake cycle regulation. The GABA A receptor is the site where sleep-inducing drugs such as diazepam have their effects, and recent research suggests GABA A receptor antagonists may be useful in the treatment of hypersomnia.1 We sought to learn if clarithromycin, an antibiotic with GABA A receptor antagonistic properties, would be benefi cial in the treatment of KLS. REPORT OF CASEWe report a 23-year-old female with KLS beginning at 10 years of age. Her diagnosis was consistent with ICSD-2 criteria and based on recurrent symptoms of hypersomnia, hypersexuality, irritability, and child-like behavior with a dreamlike state.2 KLS episode triggers included alcohol, upper respiratory infections, and general anesthesia. She slept 14 to 18 h/night during hypersomnia episodes, which could last from weeks to months. She typically had headache, nausea, and vomiting at episode onset. MRI perfusion showed episode related reductions in thalamic perfusion.3 Episode length and duration were variable, but over time they had decreased in severity allowing performance of some of her daily life functions. Between episodes her sleep duration was approximately 9 h/night with normal mood and activity levels. She had no comorbid illness and took no regular medications. She had tried a number of medications for KLS, including prazosin, acetazolamide, methylphenidate, and liothyronine, all of which were discontinued due to either side effects or ineffectiveness. In the midst of a recent episode she had been started on clarithromycin 500 mg every 12 hours. She was on no other medications at that time. Within 24 h, her sleepiness

Objectives: This study aimed to evaluate the incidence of coronary artery ectasia (CAE) and its associated factors in the East of Iran. Methods: A cross-sectional study was conducted on 2,795 patients undergoing coronary angiography between 2011 and 2017. Patients were categorized into three groups: Coronary artery ectasia, normal coronary artery, and coronary artery stenosis. Patients' demographic data, cardiac risk factors, and angiographic results were extracted from medical records. Then, information on CAE patients was evaluated. Data were analyzed by the independent t-test, Mann-Whitney test, and chi-square test. Statistical significance was defined by a P-value ≤ 0.05. Results: The prevalence of CAE was 3.04%. The mean age of CAE patients was significantly higher than that of normal coronary artery patients (53.98 ± 9.97). The proportion of men was significantly lower in the CAE group (48.2%) than in the CAS group (62.1%) but higher than in the normal group (32.3). Body mass index (BMI) and low HDL (high-density lipoprotein) were higher in the CAE group, but diabetes mellitus was lower than in the CAS group. Conclusions: The prevalence of CAE was low in our study. Old age, male sex, obesity, and low HDL were CAE risk factors, but diabetes mellitus was a preventing factor in our study.